Dka. The switched from prozinc to lantus

[Keiko and Sara]

Hi. Keiko has been stable on 2.25 units of prozinc for a while. I haven't updated his spreadsheet since my random checks were fine.
I brought my cats to my mom's for the Easter long weekend. This is the first time in about a decade the cats left my place. Do to unpleasant upstairs neighbours I had to leave (I was severely sleep deprived).
Keiko crashed on Tuesday April 7, 2026. He puked once all over himself and then again black. Was not interested in any food or water. He the proceeded to fall down the stairs. He was dragging his back legs. I tested him as I was worried about hypo. He was really high. He then proceeded to puke again. I called the local vet here and I brought him in fearing dka. His blood work came back with a bunch of red. Main concern was glucose value of 30.53mmol/L and ketones in his urine.
There are no 24/7 vets here. They could keep him until 7pm each day and I must pick him up and bring him back at 8am. I was quoted about 10k from the Emerg vet out of town and I could not afford it so decided to go with the daytime testing here. He was there Tuesday to Friday during the day where he received fluids and fast acting insulin. I was advised since he ate each day there to continue with my normal dose of prozinc insulin. He'd go way back up overnight. The vets here typically deal with lantus so wanted me to change for the Thursday evening shot. I agreed. They were afraid of a straight unit change and decided to lower it to 2 units lantus for the first few days with the idea of going to 3 units since 2.25 prozinc wasn't working anymore (we were going to increase the dose before deciding to switch to lantus).
I now realize that lantus is more important for nadir testing then preshot so I got a Libre 3 sensor installed on him. I'm having the worst time getting his ear to bleed since the dka. I have confirmed the hi reading with my contour next. We are now at 3.5 units but I'm unsure if I should dial it back now that I have the Libre on him or should I proceed. I was thinking of trying the tight regulation. I'm very scared of dka again as this has eaten all my savings and honestly seeing him that way was extremely heartbreaking.
The libre has been a complete flat line always reading hi. It has not come down at all (just over 24 hours at this point).
Sorry if this is confusing. Any advice would be greatly appreciated.

 

[Jessica & Indy]

What that means is that he is above 400. The Libre can't process numbers higher than that. Keep in mind that with SLGS you hold doses for 7 days to give the Lantus depot a chance to work. If you switch to TR then you only have to hold doses for 6 cycles but no dry food. @Staci & Ivy is one of resident libre experts.

 

[Wendy&Neko]

Could you put a blank line between the last day of Prozinc and the first day of Lantus and label it "start Lantus" or something like that. The top of your spreadsheet says "current insulin Prozinc". Since Lantus is a depot style insulin, we need to know how long he's been on it. Also, put in the Remarks what day he came home.

Are you home testing for ketones? You can get either blood meters that test for it, or urine strips. Tips to catch and test a urine sample At this stage, you need to test regularly for ketones. He also needs to eat about 50% more than his regular amount of food. How is his appetite?

Please don't react to higher numbers with increases, without giving the insulin depot time to build, so you can see what the dose can do. I'm a little worried that if he was getting blue numbers (under 200) with 2.0 units insulin that you've now increased him to 3.5 units. When it could be just a bounce causing those higher numbers.